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Bilateral TKR The Historian - recovery diary

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You are doing remarkably well with your rehab. Every case is different and this is partially but importantly due to mental attitude and fortitude. In your case those attributes are paying off well. Keep going strong. I stayed in the rehab facility six days and my condition as far as leg straitness was no where near the severity of yours or Roy's. Further down the road the soft tissue changes you will need to get to a greater ROM will be a challenge. Consider massage therapy. When you get to that point.
 
Hi Historian: Happy that you are on the other side. You'll have your ups and downs, but you will love your new knees in a few months. Was it your understanding that the nerve damage caused by straightening would resolve in time? I have some of that too, but I always have a positive attitude that all will be well in the end.
I give thanks that you have a loving church family that will take care of you physically and spiritually. God Bless, Vicki C.
 
Glad to see u on the other side may god be with you and give you strenght will look for more post and will soon join u here
 
Historian....I'm so happy to hear how well you're doing. I agree with Roy that you may have some rough spots later on, but after all you've been through prior to surgery, this may seem like a "walk in the park." (bad pun....sorry!)

Bravo and keep the reports coming!!! You made me smile today!
 
ruppbike said:
Haven't heard from you in awhile, Historian. Hope your recovery is going well.
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Minor problem kept me away from the keyboard - a CT scan revealed a PE and so a day before discharge I was rushed to another hospital. I was released on Friday night and I'm home now, taking Lovanox and setting up home care. My Coumadin levels should be high enough by Monday I can stop the Lovanox, if the doctor says so.

Meanwhile I've discovered my home is a lot less prepared for my return than I expected......:rolleyespink:
 
Oh no! Are you alright now? And are you coping though your home isn't well prepared?
 
Josephine said:
Oh no! Are you alright now? And are you coping though your home isn't well prepared?
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I still have the clots, of course, with all the drawbacks they present. So my stamina is considerably reduced. My heart rate climbs if I walk too far. Which of course puts me in a Catch 22 situation, with my energy level being hardly above sedentary its a struggle to get the blood flowing.

As for the home, I'm coping, but not well. I needed help getting out of a chair tonight. I was so frustrated I shouted it would have been better if God had taken me during surgery. I'm a person who does things. Being passive and inactive is almost as much a death as the real thing.
 
Just to get your opinions, here's the sequence of events for the past week:

I felt very run down last weekend, but I wrote it off as the work of the week catching up to me. The rehab hospital has a full schedule of PT and OT on weekends, and despite fatigue I met my goals. I had a flexion of 107 and an extension of 5 on each leg. I could stand five minutes and put a jigsaw puzzle together without trouble. I could walk around the gym with my walker without trouble, use the bathroom, and spent 4 hours a day on CPM machines.

Monday I suffered a loss of appetite, vomiting, and a fever that reached 102.5 before it broke. Tuesday was my "performance day" before discharge. I completed the OT showering and dressing program, but I began to have a racing heart and lower O2 content during PT. The therapist probably saved my life by stopping the session and taking my data to the doctor in charge. An hour later I was being transferred by ambulance to a neighboring hospital for a CT scan. I was diagnosed with a PE a couple of hours later.

Where did I go wrong above? Was this triggered by the fever on Monday?
 
Mr Google says "A pulmonary embolism is a sudden blockage in a lung artery, usually due to a blood clot that traveled to the lung from the leg."
Where did I go wrong above? Was this triggered by the fever on Monday?
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You didn't do anything wrong. These things happen, apparently. It happened to a lady in the same place as me, Mr Ireland later commented "haven't had one of those in over 2 years."
Being passive and inactive is almost as much a death as the real thing.
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So I as a natural lazyar lazybones was in my element in the first few weeks, you have a challenge. But thereafter you will be fine where my challenge begins and continues -- you are the lucky one, sorry but there it is.

You might think of it as proactive recovery practice rather than just lazing about.
 
Roy Gardiner said:
Mr Google says "A pulmonary embolism is a sudden blockage in a lung artery, usually due to a blood clot that traveled to the lung from the leg." You didn't do anything wrong. These things happen, apparently. It happened to a lady in the same place as me, Mr Ireland later commented "haven't had one of those in over 2 years."
So I as a natural lazyar lazybones was in my element in the first few weeks, you have a challenge. But thereafter you will be fine where my challenge begins and continues -- you are the lucky one, sorry but there it is.

You might think of it as proactive recovery practice rather than just lazing about.
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Thanks for the support, friends. I was very down yesterday, as you could guess. But today is new, I can look out my living room window and see the wind blowing the trees on the neighboring farm. The cows aren't in the lower pasture today, but many times they are:



God gave us a wonderful world, and there's no use for me to whine; I'll be back out there soon enough:









In the meantime, I got out of bed this morning without help, and I put on my socks without the silly dressing tool rehab gave me. I'll take the successes as I make them.
 
Don't think I posted this before. Here's the left knee eight days after the surgery:
 
So glad you are home now and recovering. That's a bit of a scare to have a PE! I had a DVT behind my right knee nine years ago and had to be on Lovenox briefly and then Coumadin for six months. That was when my knee problems really started. I worried about DVTs with both of my knee replacements but they used a combo therapy of Lovenox first in the hospital and then Coumadin for four weeks (I just stopped my dosage for "Buzz", as I call my left knee).

You certainly did not do anything wrong to get a blood clot! Keep doing those ankle pumps, though.

Nice pictures!
 
The visiting nurse has come and gone. I'll get the results of the blood draw tomorrow. Meanwhile everything else looked good: blood pressure, O2 content of blood, pulse, incisions, leg swelling, breathing.... it takes me five seconds to reach a standing position. Nurse was surprised I was only on one pain drug (Lyrica for the nerve damage in my feet); I explained I was a differently abled athlete, and soreness and stiffness are what I'm used to.
 
Once you are done with the home health phase, things should pick up for you. Down days are just that, down. Things do improve. On the knee's schedule, not yours.

Every day is a gift. How you accept that gift is up to you.
 
This is going to be one of those updates that I warned you about.....

On Monday I had blood drawn for my INR levels. I called my doctor Tuesday afternoon looking for the results. They hadn't received them. I called the Home Care Network (run by Jefferson Hospital in Philadelphia) looking for the results. They said they would try to reach the nurse and the lab (Qwest Diagnostics). My doctor called me back in a high dudgeon - "I have a patient with a life-threatening condition and a bleeding risk and I don't have blood readings since Friday morning?!" I called HCN who told me the nurse had the day off and she wasn't responding to phone calls, and the lab claimed they never got the sample. After another call from my doctor, who calmed down enough to remember I'm the victim here, we discussed options. Instead of sending me immediately to a local hospital emergency room for a blood draw, he arranged for a mobile lab to draw blood at my home this morning. Meanwhile what happened to Monday's sample we don't know. Perhaps the nurse is walking around with a vial of my blood in her pocket? Women have kept odder things of mine....

My doctor in the meantime reviewed my scripts and history from the hospital, and considers the blood monitoring as "inept." I've been bouncing between 1.6 and 1.9 INR for ten days and no one increased my script for Coumadin. Also, Lovanox comes in a 150 MG needle, but the hospital doctor on advice of the pharmacy gave me 60 and 80 - thus shorting my dose. So my doctor has written new scripts which I can pick up tomorrow at my local pharmacy, subject to a possible change depending on my blood reading this morning.

Physical therapy started today.... sort of. It was more instruction than suffering. The sufferfest starts Thursday......

Meanwhile I'm coping as best I can. I still can't get out of the chairs in the living room. I spend all day in the dining room, since those are the only chairs I can get out of. I'm a little more mobile in the kitchen, and I'm making my own meals - instant, of course. The commode my insurance paid for is destined for eBay, since I can use the toilet without problems. The shower, however, is another story. The head is a non-standard "fixed" model and I need a hand-held lest I flood the bathroom when I bathe. We got this last night and I hope to be able to shower today. I've been using my camping trick of cleaning myself with alcohol hand sanitizer, but that only works so long. I'm dirtier than I've ever been. I had a dream my photo was used for a story on Occupy Wall Street in the Huffington Post....
 
Hint for anyone going in the hospital.... whenever you are given a pill, always ask what it is. When they tell you, ask what it does. Even in the hospital you should know precisely what you are taking and why you are taking it. Too many nurses are like a defective vending machine - press a button and you get the wrong item. As evidence I cite my constant argument with the nurses about stool softeners - the nurse would insist I take one even though I rang the bell five times a night to fetch a bedpan.
 
Hi there, I hope you can get your shower sorted, it does make all the difference to feel the water on your back. I am used to sailing and I have been known to go for days without a shower (hubby was always keen to conserve the water), I would use the wet wipes but it's just not the same.

Take care and keep up the good work!
 
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